psychiatryПСИХИАТРИЯPsychiatry (Moscow) (Psikhiatriya)1683-83192618-6667FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»10.30629/2618-6667-2022-20-2-85-96psychiatry-829Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSПсихические расстройства репродуктивного цикла у женщинMental Disorders of the Female Reproductive Cyclehttps://orcid.org/0000-0001-8653-596XМедведевВ. Э.MedvedevV. E.

Владимир Эрнстович Медведев, кандидат медицинских наук, доцент, заведующий кафедрой психиатрии, психотерапии и психосоматической патологии

Москва

Vladimir E. Medvedev, Cand. of Sci. (Med.), Associate Professor, Head of Department of Psychiatry, Psychotherapy and Psychosomatic Disorders

Moscow

Medvedev_ve@pfur.ruФГАО ВО «Российский университет дружбы народов»РоссияPeoples’ Friendship University of Russia (RUDN University)Russian Federation2022080720222028596Copyright © Медведев В.Э., 20222022Медведев В.Э.Medvedev V.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journalpsychiatry.com/jour/article/view/829

Обоснование: психические расстройства, связанные с генеративным циклом женщины (предменструальный период, беременность, лактация, бесплодие, перименопауза), являются клинической реальностью на протяжении всей истории изучения факторов психосоматического здоровья женщины. В новейшей классификации МКБ-11 выделяется самостоятельная категория 6Е20–6Е21 «Психические расстройства, ассоциированные с репродуктивным циклом». Клинико-этиологическое разнообразие психических расстройств репродуктивного цикла у женщин обусловливает необходимость комплексного подхода к диагностике и выбору методов лечения. Цель: провести анализ результатов основных научных исследований, касающихся патогенетических и клинико-динамических характеристик психических расстройств репродуктивного цикла у женщин. Материал и методы: по ключевым словам «психические расстройства, предменструальный синдром, беременность, бесплодие, лактация, перименопауза, инволюция» проведен поиск в базах данных статей отечественных и зарубежных авторов (PubMed, eLibrary, Scopus и ResearchGate), опубликованных за последние 25 лет. Заключение: в представленном обзоре проанализированы результаты исследований, в которых показано, что разнообразные психоэмоциональные стрессы и эндокринологические отклонения на разных этапах генеративного цикла женщин являются факторами риска развития психических расстройств. Клинические описания психических расстройств включают гетерогенные и полиморфные тревожные, аффективные, дисморфические и психотические симптомокомплексы. При этом отсутствие ясного понимания их патогенеза приводит к сохранению разногласий по вопросу: являются ли эти расстройства (послеродовой психоз, инволюционная меланхолия/истерия и др.) независимыми психическими расстройствами или провоцируемыми экзацербациями других психических заболеваний у женщин, имеющих предрасположенность. Представленный обзор позволяет расширить знания о клинических вариантах психических расстройств репродуктивного цикла у женщин, факторах риска их развития, что имеет важное практическое значение в диагностике и выборе методов лечения.

Background: Mental disorders associated with the female reproductive cycle (premenstrual period, pregnancy, lactation, infertility, perimenopause) have been a clinical reality throughout the history of the study of psychosomatic health factors in women. The most recent ICD-11 classication distinguishes an independent categories, “Mental or behavioral disorders associated with pregnancy, childbirth and the puerperium, with/without psychotic symptoms”. The clinical and etiological variety of mental disorders associated with female reproductive cycle (MDFRC) requires an integrated approach to diagnostics and choice of treatment methods. Objective: to analyze the results of the main scientic studies concerning pathogenetic and clinical characteristics of MDFRC. Material and methods: the key words “mental disorders, premenstrual syndrome, pregnancy, infertility, lactation, perimenopause, involution” were used to search the databases of articles of domestic and foreign authors (PubMed, eLibrary, Scopus and ResearchGate) published over the past 25 years. Conclusion: The presented review analyzed the results of studies showing that a variety of psychoemotional stresses and endocrinological abnormalities at different stages of the female generative cycle are risk factors for the development of psychiatric disorders. MDFRC include heterogeneous and polymorphous anxiety, affective, dysmorphic, and psychotic symptom complexes. However, the lack of a clear understanding of their pathogenesis leads to persistent disagreement as to whether MDFRC (postpartum psychosis, involutionary melancholia/hysteria, etc.) are independent psychiatric disorders or provoked exacerbations of other psychiatric diseases in predisposed women. The presented review allows to improve understanding of MDFRC, their risk factors and clinical variants, which has important practical value in diagnostics and choice of treatment methods.

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The authors declare that there are no conflicts of interest present.